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Federal forms, ICRs, and supporting documents

Information Collection

Supporting and Strengthening the Home Visiting Workforce (SAS-HV): Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting

IC 270328 under ICR 202412-0970-003 · OMB 0970-0355.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Instrument 1_Participant and Contextual Characteristics Questionnaire 3-19-24_CLEAN.docx Other-Questionnaire
Instrument 2_Focus Group Protocol for Relevance Across Racial and Ethnic Subgroups, 1-10-24, CLEAN.docx Other-Focus Group Protocol
Instrument 3_ Reflective Supervision Measure, 3-19-24_CLEAN.docx Other-Reflective Measure
Instrument 4_ Participant Perspectives on Reflective Supervision Measure, 3-19-23 CLEA.docx Other-Reflective Measure
Instrument 5_Measures to Examine Convergent and Concurrent Validity, 12-15-23_CLEAN.docx Other-Validity Measure
Instrument 6_Supervisor Questionnaire for Repeated Measures, 3-19-24_CLEAN.docx Other-Questionnaire
Instrument 7_Supervisee Questionnaire for Repeated Measures Sample, 1-17-24, CLEAN.docx Other-Questionnaire
Instrument 8_Focus Group Protocol for Repeated Measures Supervisor Subsample, 1-10-24, CLEAN.docx Other-Focus Group Protocol
SAS-HV OSC4 Draft SSA OMB 1-17-24, CLEAN.docx
SSA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting		IC Document
SAS-HV OSC4 Draft SSB OMB 1-10-24 CLEAN.docx
SSB - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting		IC Document
Recruitment appendices SAS-HV OSC4a OMB package 1-10-24, CLEAN.docx
Appendices - Recruitment Materials		IC Document
Change Request SAS-HV 3-19-24_CLEAN.docx
NonSub Change - SAS-HV Feedback Updates		IC Document
NOA_SAS-HV 3_NonSub Change_Pretesting GenIC_0970-0355_4.1.24.pdf
NOA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaire Yes Yes Fillable Fileable
Other-Focus Group Protocol Yes Yes Printable Only
Other-Reflective Measure Yes Yes Fillable Fileable
Other-Reflective Measure Yes Yes Printable Only
Other-Validity Measure Yes Yes Fillable Fileable
Other-Questionnaire Yes Yes Fillable Fileable
Other-Questionnaire Yes Yes Fillable Fileable
Other-Focus Group Protocol Yes Yes Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,570 0 0 0 0 1,570
Annual IC Time Burden (Hours) 810 0 0 0 0 810
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
SSA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting 08/22/2024
SSB - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting 08/22/2024
Appendices - Recruitment Materials 08/22/2024
NonSub Change - SAS-HV Feedback Updates 08/22/2024
NOA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting 08/22/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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